Intervertebral Disc Health Research Articles

MRI signal distribution within the intervertebral disc as a biomarker of adolescent idiopathic scoliosis and spondylolisthesis

BackgroundEarly stages of scoliosis and spondylolisthesis entail changes in the intervertebral disc (IVD) structure and biochemistry. The current clinical use of MR T2-weighted images is limited to visual inspection. Our hypothesis is that the distribution of the MRI signal intensity within the IVD in T2-weighted images depends on the spinal pathology and on its severity. Therefore, this study aims to develop the AMRSID (analysis of MR signal intensity distribution) method to analyze the 3D distribution of the MR signal intensity within the IVD and to evaluate their sensitivity to scoliosis and spondylolisthesis and their severities.MethodsThis study was realized on 79 adolescents who underwent a MRI acquisition (sagittal T2-weighted images) before their orthopedic or surgical treatment. Five groups were considered: low severity scoliosis (Cobb angle ≤50°), high severity scoliosis (Cobb angles >50°), low severity spondylolisthesis (Meyerding grades I and II), high severity spondylolisthesis (Meyerding grades III, IV and V) and control. The distribution of the MRI signal intensity within the IVD was analyzed using the descriptive statistics of histograms normalized by either cerebrospinal fluid or bone signal intensity, weighted centers and volume ratios. Differences between pathology and severity groups were assessed using one- and two-way ANOVAs.ResultsThere were significant (p < 0.05) variations of indices between scoliosis, spondylolithesis and control groups and between low and high severity groups. The cerebrospinal fluid normalization was able to detect differences between healthy and pathologic IVDs whereas the bone normalization, which reflects both bone and IVD health, detected more differences between the severities of these pathologies.ConclusionsThis study proves for the first time that changes in the intervertebral disc, non visible to the naked eye on sagittal T2-weighted MR images of the spine, can be detected from specific indices describing the distribution of the MR signal intensity. Moreover, these indices are able to discriminate between scoliosis and spondylolisthesis and their severities, and provide essential information on the composition and structure of the discs whatever the pathology considered. The AMRSID method may have the potential to complement the current diagnostic tools available in clinics to improve the diagnostic with earlier biomarkers, the prognosis of evolution and the treatment options of scoliosis and spondylolisthesis.

Intervertebral Disc Health Preservation After Six Months of Spinal Growth Modulation

Spinal growth modulation has been proposed as a non-fusion strategy for treatment of idiopathic scoliosis, although the effect of this treatment modality on intervertebral disc health has not been evaluated in detail. The objectives of this in vivo study were to assess the creation of three-dimensional spinal deformity during six months of growth modulation compared with that in sham-surgery controls, and to compare, with use of magnetic resonance imaging (MRI), gross morphological, histological, and biochemical analyses, disc health between control animals and animals treated with a spinal tether. Six immature Yucatan mini-pigs underwent anterior spinal instrumentation with vertebral screws connected by a polyethylene tether over four consecutive thoracic vertebrae (T8-T11). An additional six animals underwent sham surgery (screw placement only [the control group]). Radiographs were obtained preoperatively, postoperatively, and monthly thereafter during six months of growth. Computed tomography (CT) and MRI studies were performed ex vivo, and the spines were sectioned for histological and biochemical analyses. Multivariate analysis of variance (MANOVA) was used to compare six-month postoperative data between the control and tethered animals, with the alpha level of significance set at 0.05. Radiographs and CT images demonstrated the creation of significant three-dimensional deformity (p < 0.013) in the tethered animals compared with the controls. Macroscopic, MRI, and histological evaluation revealed no signs of disc degeneration, with a bulging gelatinous nucleus pulposus, discrete fibrous anular lamellae, and uniformly hyperintense T2-signal intensity within the nuclei pulposi. Biochemical analysis demonstrated no significant difference in the nuclei pulposus between the tethered and control vertebrae; however, the water content (p < 0.001) of both sides of the anulus fibrosus and the glycosaminoglycan content (p < 0.001) of the left side of the anulus fibrosus differed significantly between the two groups. Six months of spinal growth modulation created significant spinal deformity in all three planes compared with what was found in the sham-surgery controls. Although disc health was qualitatively maintained, quantitative changes in the anulus fibrosus water content and the disc height were observed on the side opposite to the tether. These changes likely represent metabolic responses of the discs to compressive loads generated by the flexible tether.

Rat Intervertebral Disc Health During Hindlimb Unloading: Brief Ambulation With or Without Vibration

Changes in intervertebral disc (IVD) morphology and biochemistry have been characterized only incompletely in the rat hindlimb unloading (HLU) model. Here we present preliminary data on the differential effects of short periods of weight-bearing with or without low-level whole-body vibrations (WBV) on the lumbar rat IVD during HLU. Rats were subjected to HLU and exposed to daily periods (15 min x d(-1)) of either ambulatory activities (HLU+AMB) or whole body vibrations superimposed upon ambulation (HLU+WBV; WBV at 45 Hz, 0.3 g). At the end of the 4-wk experimental period and compared to age-matched control rats (AC), the lumbar IVD of HLU+AMB had a 22% smaller glycosaminoglycans/collagen ratio, 12% smaller posterior IVD height, 13% smaller cross-sectional area, 9% greater ratio of height/area, and a 24% smaller volume of the surrounding muscle tissue. Compared to HLU+AMB rats, the addition of low-level vibratory loading did not significantly alter IVD biochemistry, posterior height, area, or volume but normalized muscle volume (-8% vs. AC) and the IVD height/area ratio (-3% vs. AC) to levels similar to normal controls. Relative to AC, superposition of the vibratory stimulus onto ambulation had a greater effect on IVD area than on IVD height. IVD volume and IVD posterior height of HLU+WBV rats remained 13% and 16% smaller than in normal controls. Even though neither intervention was successful in preventing hindlimb unloading induced changes in IVD volume, compared to ambulation alone, very low-level whole-body vibrations resulted in greater total back and abdominal muscle volume and directionally altered IVD geometry.

F-actin cytoskeletal organization in intervertebral disc health and disease

The cytoskeleton, which in most cell types, including the intervertebral disc described here, comprises microfilaments, microtubules and intermediate filaments, plays important functions in many fundamental cellular events, including cell division, motility, protein trafficking and secretion. The cytoskeleton is also critical for communication; for example, alterations to the architecture of the F-actin (filamentous actin) cytoskeletal networks can affect communication between the cells and the extracellular matrix, potentially compromising tissue homoeostasis. Although there are limited studies to date, this paper aims to review current knowledge on F-actin cytoskeletal element organization in intervertebral disc cells, how F-actin differs with pathology and its implications for mechanotransduction.

Effect of limited nutrition on intervertebral disc health: an in vitro investigation on whole organ disc explants with endplates

Effect of limited nutrition on intervertebral disc health: an in vitro investigation on whole organ disc explants with endplates